When people choose health research as a career, it’s often with the hope that one day they will discover something significant that will positively impact the health and well-being of people. When that hope becomes a reality, their first instinct may be to go to a policy-maker who can implement their findings over a large population. There are, however, a few things you should consider before you go knocking on the door of a policy-maker.
Enthusiasm can tempt people to aim high right off the bat, but often building up will increase impact over the long run. Before you try to approach a government official, ask yourself whether or not you are addressing the right level of policy-makers. If your evidence is untested in the real world, implementation within a department, a health system, or at the municipal level might be the better option for now. Smaller, context specific successes can be used later as evidence when the time is right to approach higher levels of government. Think critically about where it can be realistically implemented and serve the greatest number of people quickly.
In general, government-level policy-makers are well-educated and informed. They appreciate the value of research and evidence. However, they are also working under many constraints that may prevent them from embracing your work wholeheartedly. For example:
A policy-maker’s decisions must follow the mandate to which the government was elected, and/or the current ministerial business plan. Do your recommendations match at least one of those two things? If they don’t, is there a way to frame your recommendations to follow them?
Policy-makers have budgets that have to be followed. Their decisions need to result in the greatest number of benefits, for the greatest number of people, for the best price. Therefore, proposing costly recommendations that serve only a small group is not in your best interest, unless they result in substantial cost savings.
In a democratic society, the government is accountable to the electorate, and that will influence what choices are made. Does your evidence address a problem that the public believes is important? Have you taken the time to engage with members of the public, or specific stakeholders to determine if you agree on what the root of the problem is?
“Politics” occurs when journalists or special interest groups speak out and draw attention to controversial decisions or actions made by the government. Would your recommendations spark this sort of unwanted interest?
Windows of opportunity refer to the very short timeframes in which policy-makers make decisions about a particular issue. Often these occur within the first year after an election when a government makes sweeping changes to initiate its’ mandate. They can also occur when there is a crisis, or a particular problem is drawing a lot of attention. It is during these short time slots that it is important to present your evidence and recommendations.
Once final decisions are made, and a policy is in place, the window is shut until the next election, unless problems arise. If your goal is to approach a policymaker, be sure to keep track of their ongoing activities. Windows of opportunity are rarely announced. However, if you find that you have missed that window of opportunity, don’t let that stop you from starting the process. This is a great time to build relationships and start a dialogue with policy-makers. For example, you can send a policy brief (described below) and see if it starts a conversation. You can try offering your support and expertise in other policy work that is more pressing. You can also tParagraph(s)ry leveraging existing relationships with well-connected friends or establish new connections by working with organizations that are already well-connected with policy-makers. These activities take time but will pay off in the long-term. Just recognize that your ideas will not likely be considered until the next window opens.
Integrated knowledge translation (iKT) involves the inclusion of end-users and stakeholders during the development, execution, and evaluation of a research project. The purpose of iKT is to improve uptake by making the research relevant for the end-user. If you want your evidence to be translated into policy, policy-makers need to be at that iKT table too. In general, upper level policy-makers (eg. deputy ministers) do not have time to participate as stakeholders, but they are surrounded by advisors and other colleagues that can serve in this capacity.
Why is it so important to include policymakers in your iKT strategy? Firstly, you might be surprised to find that the government has a completely different view of the root cause of a given complex problem. To ensure success in translating your evidence into policy, it is important that everyone is solving the same problem. Secondly, when a policy decision is being made, time is of the essence. Mulling over ideas with a long list of experts is simply not feasible. They will go to the expertise they trust, and that trust is built through relationship. Finally, policy is rarely a decision made by a single individual. It is usually determined by multiple internal and external players placed in different networks. To navigate through the tangles, it’s good to have people on your side who understand the system.
As mentioned above, policy-makers have a healthy appreciation for evidence, so it is important that your evidence is solid. High-quality systematic reviews are one great way to demonstrate the validity of your evidence. Even more compelling, however, are comparators. Comparators are context similar jurisdictions where comparable recommendations were implemented, and improvements were observed. Seeing that this evidence worked elsewhere can help the policy-maker feel confident that this will not be a waste of resources.
As mentioned earlier, government-level policy-makers are very busy, and you want to make this process as easy as possible for them. They do not have the time to create solutions based on your evidence. Therefore, it is critical that you are presenting more than just your data. Ideally, you should include three concrete policy recommendations based on the evidence that you are presenting. These three recommendations can be three different solutions, or they can be three different recommendations/steps within a single solution. In addition to your three recommendations, you need to have an implementation plan ready to go.
The policy brief (also called evidence brief) is a knowledge transfer tool specific for policy-makers. In general, they follow a format that includes a summary of the problem, the context, the evidence, and the policy recommendations that will help resolve the problem. Policy-makers have indicated that this is their preferred mode of receiving new ideas.
These 2-4-page documents require a very different style of writing compared to academic documents, so it’s a good idea to look at examples, or even recruit someone who has experience writing policy briefs. There are many great resources available including guidelines, publications, webinars, and templates that you can access if you need help.
It’s important to note that policy briefs are merely meant to spark interest and initiate dialogue between policy-makers and the research team. Real impact and change are achieved mainly through on-going, collaborative discussions with policy-makers.
Like any other KT strategy, engaging with policy-makers takes planning, time, and a variety of skills. For example, if you are used to communicating only with other academics, or health professionals, it might be valuable to bring in someone “savvy” as this process requires persuasive communication skills.
Thankfully, there are endless resources to help you if you decide you want to give reaching out to policy-makers a try. If you click on any of the links throughout this blog post, they will take you to valuable pages, tools, and webinars. The McMaster Health Forum is a great source of information. For example, this particular tool is designed is for a policy-maker to assess the evidence strength of a proposal. For a researcher, this same tool acts as a very helpful readiness checklist. The Cochrane Collaboration has a great series of videos with Dr. John Lavis discussing how to make your evidence syntheses policy-relevant. Also, a whole library of tools can be found at the National Collaborating Centre for Methods, and Research Impact Canada has a number of blog posts and publications on the topic.
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